Indent in my nose that was never there before - what can be done? (photos)

Hello and thank you for your question.  This is likely due to warping of your lower lateral cartilage.  Based on your photographs, you may benefit from a tip refining rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. This can be designed to improve this area of asymmetry.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system.  You should be able to view numerous pictures of actual patients with noses similar to yours performed by your surgeon.  If you cannot find enough real before and after pictures, then consider continuing your search for a surgeon. Best wishes and good luck.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon
 

  The photographs demonstrate a portion of your lower lateral cartilage that is concave in shape, not convex  like the other side.  Both cartilages are usually convex.  A surgical closed rhinoplasty can accomplish augmenting the depressed area with a very small softened and morselized cartilage graft harvested from inside the nose to fill in that area on a permanent basis.  This will make the left and the right nasal tip much more symmetrical. All incisions were placed on the inside of the nose.  No external incisions are required.

It could be from a number of reasons but the simplest thing to try would be to use a filler to see if it can be corrected. This may not be permanent but is simpler than a rhinoplasty. If this does not work then the tip rhinoplasty would be next. If the cartilage looked OK at the time of surgery, a small cartilage graft to fill in the depression would be considered.